{"entity":{"id":"idea-acc-time-toxicity-reporting","kind":"idea","name":"Report time toxicity, the days spent in healthcare, as a standard outcome for older patients","aka":[],"tldr":"A treatment that adds two months of life but takes up most of those days in hospitals and clinics may not be worth it to an older patient. Trials should report how many days treatment consumes.","summary":"Time toxicity, the number of days with physical healthcare contact, has been proposed as a patient-relevant outcome that is easily measurable from trial and administrative data. For older patients with limited survival, it may outweigh modest survival gains. Requiring its reporting in trials and in real-world evaluations of new therapies would inform shared decisions and could change the perceived value of some regimens.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Older and multimorbid patients are excluded and undertreated): Mohile et al., Evaluation of geriatric assessment and management on toxic effects of cancer treatment (GAP70+, Lancet 2021)","url":"https://doi.org/10.1016/S0140-6736(21)01789-X"}],"tags":[],"related":[],"cancers":[],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["os","pfs"],"trials":[],"people":[],"bottlenecks":["b-aging-comorbidity","b-toxicity-qol","b-trial-design"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Time toxicity will vary by more than fourfold between regimens with similar survival in the same indication, and presenting it in decision aids will change treatment choice for a measurable fraction of older patients.","rationale":"Days at home is a validated, patient-valued outcome in other fields; oncology has the data to compute it but does not report it.","test":"Retrospectively compute time toxicity for ten registration trials; then a randomised study of decision aids with and without time-toxicity information in patients over 75.","maturity":"speculative","actor":"research","cost":"small","horizonYears":2},"route":"/ideas/idea-acc-time-toxicity-reporting/","neighbours":{"term":[{"id":"os","kind":"term","name":"Overall survival (OS)","route":"/terms/os/"},{"id":"pfs","kind":"term","name":"Progression-free survival (PFS)","route":"/terms/pfs/"}],"bottleneck":[{"id":"b-aging-comorbidity","kind":"bottleneck","name":"Older and multimorbid patients are excluded and undertreated","route":"/bottlenecks/b-aging-comorbidity/"},{"id":"b-toxicity-qol","kind":"bottleneck","name":"Toxicity and quality of life are undervalued","route":"/bottlenecks/b-toxicity-qol/"},{"id":"b-trial-design","kind":"bottleneck","name":"Trial design, endpoints and cost","route":"/bottlenecks/b-trial-design/"}]}}